Skiff's services continue to grow with the needs of the community

Skiff has done some major projects over the years, but unlike in years past, Medicare funding has become an area of concern. Hospitals rely on programs like Medicare.

Medicare started in 1965. It was health insurance for the aged. Prior to that, not many people had insurance. Back then, Medicare paid the entire bill, but it was very expensive. The program cost more than projected, but not many people at the time lived much past the age of 65.

The program saw drastic changes once the general population lived past 65. Medicare no longer paid the total cost. It now covered the projected cost until the mid 1980s.

To reduce Medicare costs, the government introduced Prospective Payment System. PPS limited how much funding the program covered, based on location.

PPS location rates were not based on the population of seniors but on cost of living. Iowa, being a low cost state, received very little Medicare reimbursement funding and that still remains true.

Bigger cities have patients with insurance, but PPS forced small hospitals that depend on Medicare to lose money. Many small hospitals closed around the country. This caused major problems.

If the nearest hospital is 30 miles away and a major injury occurs, that person may die, so the government decided to act. Hospitals could return to the cost rate reimbursement system if they followed certain guidelines, which include the following:

• Had to be more than 35 miles away from another hospital.

• No more than 25 beds.

• Agree to not keep anybody longer than four days.

• Had to have a contract with a bigger hospital to ship patients to.

If hospitals followed those guidelines they were reimbursed 101 percent. Medicare did allow governors to wave the distance requirement because many were critical access hospitals. Iowa has 122 hospitals and 82 of them are critical access, and most are closer than 35 miles to a major hospital.

Hospitals that were reintroduced into the program are doing well, but Skiff is in between. They are not big enough or small enough to be introduced into other government programs, which means they must depend on regular Medicare funding.

There are eight in between hospitals in the state, and they struggle.

About seven years ago a developmental program was introduced. The program was meant to deal with hospitals like Skiff. It explored the option of allowing mid size hospitals to receive 100 percent of in-patient reimbursement.

The new program was introduced to the 10 lowest populated states, and it worked well. They then extended the program to next 10 lowest states, which included Iowa. Skiff was one of those hospitals, and the program is a temporary. It is meant to last five years. Skiff has been involved in the program for almost two years. Long said if the program was cut Skiff will close and 360 people would be out of a job.

Although Medicare plays a major role, the projected restructuring of the medical field will cause a major impact on how Skiff operates.

“As we move farther down the road into healthcare reform, rather than paying us to do things, they will pay us to keep people healthy,” Long said. “HMO’s are thrown out the window, the program replacing it is called ACO, Accountable Care Organizations. The program is meant to keep people healthy, so that they do not endure cost. That is the future of healthcare.”

Skiffs services continue to grow with the needs of the community.

“Our whole plan, for the future, is based off growth,” Long said. “That means physician recruitment. We are working with our local partners in the Newton Clinic, and the New Care Clinic down the street. They are the ones recruiting the physician. We are partnering with them and hope to see a few more physicians by the end of the year.”

Skiff is also looking forward to the a new medical lab opening up this year. The lab allows medical supplies to be purchased at a lower rate. In years to come, Skiff may save more money with the lab. If more hospitals use the labs services, prices will be lowered.

For Long, their location can only mean good things.

“They are going to be right here in town, and that presents us with an opportunity that nobody else will have,” Long said. “We decided to take advantage of that opportunity.”

A major renovation project that was completed was in their medical surgeon ward. New carpeting was added, walls were updated and rooms were renovated.

They have also updated their medical technology.

“We did this tremendous upgrade in technology over the years, and we have been advertising it heavily,” Long said. “We than did our market survey, and we discovered that not many people know about it. Another service we have is a large amount of medical specialist. Many patients believe that they have to go to Des Moines to see a specialist, but we have a lot specialist in town.”

To help raise money, Skiff will be holding a fundraiser April 20 titled “Skiff Gala: Night on the Town” at DMACC.

“There will be entertainment coming in from out of town, and great food,” Long said. “It will be a really nice dress-up kind of evening. This will be a fun event.”

The fundraiser will feature a dessert auction. Guest will bid on various dessert to eat at the dinner.

In June, a golf event is scheduled. Details about the event are still being worked out, but it has been a success in years past.

Although Skiff is waiting for government funding Long is proud that Skiff has remained in operation since its opening in 1921.

“The key is for Skiff to remain independent as long as possible,” Long said. “We can remain independent longer, if these government programs remain.”